Studies have been conducted to see whether antihypertensive strategies that use calcium channel blockers and ACE inhibitors are superior to older treatments with beta-blockers and diuretics.
Hypertensive patients either received the calcium channel blocker amlodipine with or without the ACE inhibitor perindopril or the beta-blocker atenolol with or without the diuretic bendroflumethiazide.
AdvertisementThe trial ran for five years, but it was prematurely stopped after concerns arose that patients taking the beta-blocker and diuretic combination were at a continued significant disadvantage. "All-cause mortality was different in those on the beta-blocker and diuretic than those on the calcium channel blocker and ACE inhibitor. There was a highly significant risk-reduction of about 15 percent in those assigned the calcium channel blocker and ACE inhibitor."
Fatal heart disease events were reduced by 10 percent for those on the newer treatment.Although this number is not significant, the trial was stopped early, and it would have likely been a higher percentage if it had continued.
Of patients on the newer treatment, all coronary events were reduced by about 15 percent. Strokes and cardiovascular mortality were reduced by about 25 percent. Additionally, patients on the older treatment had about a 30-percent greater chance of developing type 2 diabetes.